| NPI | 1659395697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: OR MD2042222) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VT 0420008981) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NM MD2017-1014) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2021-10-18 |